Active NPI
Charles L Melton, M.D.
- Cardiovascular Disease Physician
- Texarkana, TX
National Provider Identifier
1962444166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- F6942
- Practice address
- 2604 Saint Michael Dr
Ste 345
Texarkana, TX 75503-2379 - Phone
- (903) 838-5500
- Fax
- (903) 838-7402
- NPI assigned
- Jun 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | F6942 | TX | Primary |
Addresses
Primary practice location
2604 Saint Michael Dr
Ste 345
Texarkana, TX 75503-2379
Mailing address
2604 Saint Michael Dr
Ste 345
Texarkana, TX 75503-2379
Phone (903) 838-5500
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 128230001 | Medicaid | AR | |
| 3250610 | Other | AR | BLUE LINK |
| 100150730A | Medicaid | OK | |
| 8G3790 | Other | TX | BCBS OF TEXAS |
| 19559000040 | Other | AR | QUAL CHOICE |
| 97146 | Other | AR | BCBS OF ARKANSAS |
| O60068553 | Other | RAILROAD | |
| 0004314459 | Other | TX | AETNA |
| 047791102 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272412800000",
"number": "1962444166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2604 SAINT MICHAEL DR",
"address_2": "STE 345",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755032379",
"telephone_number": "903-838-5500",
"fax_number": "903-838-7402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2604 SAINT MICHAEL DR",
"address_2": "STE 345",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755032379",
"telephone_number": "903-838-5500",
"fax_number": "903-838-7402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELTON",
"first_name": "CHARLES",
"middle_name": "L",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-12",
"last_updated": "2010-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "TX",
"license": "F6942",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "128230001",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE LINK",
"identifier": "3250610",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100150730A",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF TEXAS",
"identifier": "8G3790",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "QUAL CHOICE",
"identifier": "19559000040",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF ARKANSAS",
"identifier": "97146",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "O60068553",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0004314459",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "047791102",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Texarkana, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.